Worker's Compensation

The Massachusetts Workers’ Compensation Act, codified at
Massachusetts General Laws Chapter 152, attempts to compensate workers
for injuries suffered on-the-job, regardless of whether the
worker’s employer was to blame for the injury. The law also forbids
workers from suing their employers in court, under the jury system, if
the employer is to blame for the worker’s injury.

The nice part of Worker’s Compensation is that workers will be
compensated for an injury, even if it the injury was caused by their own
carelessness, rather than their employer’s. The downside of
Worker’s Compensation is that workers lose their right to sue their
employers in court. In effect, the net result is that workers in
Massachusetts virtually always recover for their on-the-job injuries,
however, the amount that some workers recover is much smaller than if
they were allowed to sue in court and receive a jury trial on a
negligence claim.

It should be noted that the Worker’s Compensation Act generally
only forbids lawsuits brought against the employer. It does not prohibit
so-called “third-party claims.” So, for example, if a worker
severs a finger on-the-job while using a defective table saw, he cannot
sue his employer in court but he may bring a products liability action
against the saw’s manufacturer because the saw was defective. This
claim against the saw’s manufacturer would be called a
“third-party” claim. In other situations, a third-party claim
may be brought against a landowner, a project manager or another
contractor that was on the job.

What is the first thing I should do if I am injured?

Contact an attorney at your earliest opportunity. An attorney can fill
out the Department of Industrial Accident’s Form 101 for you. This
form gets the ball rolling on your claim. The insurer then has fourteen
days to respond.

When should I start receiving a check?

If the Worker’s Compensation insurance company that your
employer uses agrees that it is liable, the insurer will send you an
Insurer’s Notification of Payment – Form 103. You will then
start receiving your checks. Generally speaking, this happens three to
four weeks after your injury.

Unless you miss more than 21 days of work because of your injury, you
will not receive benefits for the first five days that you missed.

An important note: just because the insurance company agrees to start
paying your benefits does not mean that the insurance company is
admitting liability and admitting that they owe you anything. In fact,
the first six months of your case are a “Pay Without
Prejudice” period, meaning the insurer can pay you but later change
its mind that it owes you anything.

What if the Worker’s Compensation insurer denies my
claim?

Contact an attorney.

What is the process like?

If the insurance company disputes the benefits, there will be a very
informal meeting between your attorney, the insurance company’s
attorney and a representative from the Department of Industrial
Accidents. This informal meeting is called a “Conciliation”
is an attempt to reach a mutually agreeable settlement.

If a settlement is not reached, the case proceeds to a Conference
before an Administrative Judge. At the end of the Conference, the judge
will either tell the Worker’s Compensation insurer that it has to
pay your benefits or rule that they are not legally required to do
so.

If you lose at the Conference, you should appeal in order to receive a
Hearing. The Hearing is a more formal proceeding. There are live
witnesses and the rules of evidence are followed.

If you lose at a Hearing, you may appeal to a Reviewing Board, made up
of six Administrative Law Judges. Reviewing Board decisions can be
appealed to the Massachusetts Appeals Court.

Are Worker’s Compensation benefits taxed?

No. They’re one of the few things in life that are tax-free.

Will I have a job when I get back from comp?

The Massachusetts Worker’s Compensation Act does not require
that your employer keep a position open for you. However, if you are able
to work at a later date, § 75A requires that you be given preference
in rehiring.

Is there a minimum amount of work I must miss before applying
for Worker’s Comp?

Technically, you need to have missed five or more days in order to be
eligible for Worker’s Comp. But the five days that you miss
don’t have to be back-to-back. And missed half-days also count.

Even so, if you’ve been seriously injured and know you’re
going to miss a lot of work, you should contact an attorney ASAP so that
he or she can get the paperwork filled out.

What about my health insurance and other benefits that I get
from work?

There is no cut-and-dried answer to this because there is no
obligation for your employer to continue your health insurance or any
other fringe benefits.